Back, Vertebral Column, Spinal Cord

Front 1

There are 33 vertebrae at birth but the 5 sacral and 4 coccygeal fuse in the adult. How many adult vertebrae are there and how are they divided?

Back 1

26 total
7 cervical
12 thoraic
5 lumbar
1 sacrum
1 coccyx

Front 2

what is the main purpose of intervertebral foramina

Back 2

to allow passage of spinal nerves (31 pairs) from the spinal cord to the body

Front 3

Describe the curvatures of the back?
Where are they?
Which way do they go?
How do they arise?

Back 3

Primary curvatures- thoracic and sacral, anteriorly concave, develop during fetal period, mimic fetal position
secondary- cervical and lumbar, anteriorly convex, arise from lifting head and walking

Front 4

what is kyphosis

Back 4

abnormal increase in the posterior curvature of the spine particularly in the thoracic region, leads to hunchback apperance

Front 5

lordosis

Back 5

abnormal increase in the anterior curvature of the spine (shoulders lean back), may be caused by weakening of the abdominal wall due to weight gain or transiently during pregnancy

Front 6

scoliosis

Back 6

abnormal lateral curvature of the spine, may be cause by absent half of a vertebrae. wedge shaped vertebrae, or asymetric weakness in back musculature

Front 7

List and locate the 5 major ligaments of the vertebral column

Back 7

1. Anterior longitudinal ligament-runs in front of vertebral bodies occipital bone to sacrum
2. posterior longitudinal ligament- runs on the posterior side of the vertebral bodies inside the vertebral canal axis to sacrum
3. supraspinous ligaments-attaches tips of adjacent vertebral spines (fuses w/ interspinous at cervical region to form ligamentum nuchae)
4. interspinous ligaments- connect adjacent vertebral spines
5. ligamentum flavum- connects lamina of adjacent vertebrae

Front 8

List the major ligaments of the vertebral column in posterially to anteriorly

Back 8

supraspinous ligament, interspinous ligament, ligamentum flavum, posterior longitudinal ligament, anterior longitudinal ligament

Front 9

which muscle groups of the back comprise the extrinsic muscles

Back 9

superficial (trapezius, latissimus dorsi, levator scapulae, rhombiods major/minor) and intermediate (serratus pa and pi)

Front 10

which muscle groups of the back comprise the intrinsic muscles

Back 10

deep (erector spinae, spinalis, longissiumus, iliocostalis)

Front 11

Describe the auscultatory triangle

Back 11

site on the back where breath sounds may be most easily heard. Boundries are the latissimus dorsi, the trapezius, and the medial border of the scapula

Front 12

describe the lumbar triangle

Back 12

site wehere pus may emerge from the abdominal wall, boudries are the latissimus dorsi, th eposterior border of the external oblique muscle, and the iliac crest

Front 13

where does the spinal cord terminate

Back 13

L1/L2

Front 14

What three meninges surrod the spinal cord

Back 14

from superficial to deep
dura mater
arachnoid mater
pia mater

Front 15

Where is the CSF protecting the spinal cord located

Back 15

the subarachnoid space

Front 16

conus medullaris

Back 16

terminal end of the spinal cord

Front 17

filum terminale

Back 17

terminal extension of the pia mater from the end of the spinal cord (conus medullaris) to the posterior surface of the coccyx

Front 18

What type of information is carried by ventral roots? Dorsal?

Back 18

ventral=motor
dorsal= sensory
mnemonic= you run out the front door

Front 19

cauda equina

Back 19

the vertical leash of nerves that form around the filum terminale. the lumbar nerves must bend down because the spinal cord terminates at L1/2 but the nerves must exit the lower lumbar vertebrae

Front 20

Describe the dividing and rejoining that occurs as nerve roots exit the spinal cord. What kind of information is being carried in each structure?

Back 20

The dorsal and ventral nerve roots pass through the intervertebral foramina and then unite to form spinal nerves. The spinal nerve the divides into dorsal and ventral rami. Dorsal roots carry sensory information, ventral roots cary motor information. The spinal nerve and the rami (both ventral and dorsal) are mixed nerves that carry both types of information

Front 21

denticulate ligament

Back 21

thickening of the pia mater between nerve roots which adheres to the arachnoid and the dura

Front 22

Describe the superior and inferior anatomy of the dura mater

Back 22

superiorly- continuous with the meningeal layer of the dura covering the brain
inferiorly- the duraends on the filum terminale at the level of the lower border of the second sacral vertebrae

Front 23

Describe the superior and inferior anatomy of the arachnoid mater

Back 23

sup- continuous through the foramen magnum with the arachnoid covering the brain
in-ends on the filum terminale at the level of the lower border of the second sacral vertebra

Front 24

describe the superior and inferior anatomy of the pia mater

Back 24

sup- thickened on each side to form the denticulate ligament which passes laterally to adhere to the arachnoid and the dura, extends along each nerve root as far as the spinal nerve.
In- terminal elongation off the lower end of the spinal cord called the filum terminale

Front 25

What are the bounderies of the intervertebral foramina

Back 25

above and below- pedicles of adjacent vertebrae
in front- vertebral body and intervertebral disk
behind- articular processes

Front 26

describe spina bifida in general

Back 26

results when the vertebra laminae fail to fuse, usually presents as lack of a spinous process
most commonly seen at lower lumbar or sacral levels

Front 27

List in order the anatomic structures that a needle would pass through when performing a spinal tap

Back 27

skin, fascia, supraspinous ligament, interspinous ligament, ligamentum flavum, fatty tissue, internal vertebral venous plexus, dura mater, arachnoid mater

Front 28

where is a disk herniation most likely to occur?

Back 28

lower lumbar and lower cervical regions usually posterolaterally within the vertebral column just lateral to the thin posterior longitudinal ligament where the annulus fibrosus is weak

Front 29

what is the significance of the vetebral venous plexus in terms of malignant disease

Back 29

there are no valves in the vasculature of this system providing a pathway for malignant disease to spread from the pelvis to the skull

Front 30

describe the unique shape to the atlas (C1)

Back 30

-no body or spinous process
-ring shapped with paired lateral masses that serve the place of the body

Front 31

describe the unique shape of the axis (c2)

Back 31

-odontoid process projects superiorly

Front 32

List 4 ways a cervical vertebrale can be distinguished from others

Back 32

1. foramen in the transverse processes
2. small body
3. small transverse process
4. flat, horizontal articular processes

Front 33

List 4 ways a thoracic vertebrae can be distinguished from others

Back 33

1. Medium body
2. Articulations for ribs on body and transverse process
3. Medium transverse process
4. flat and vertical articular processes

Front 34

List 3 ways a lumbar vertebrae can be distinguished from others

Back 34

1. Large body
2.large transverse processes
3. stout, cuplike articulate processes

Front 35

Describe the articular processes of the cervical vertebrae and explain how their shape affects their movement

Back 35

Flat, nearly horizontal processes allow for a wide range of rotation and flexion

Front 36

describe the shape of the articular processes of the thoraic vertebrae and explain how their shape affects their motion

Back 36

flat and nearly vertical. allow for forward and backwards flexion but little rotation, prevent slipping

Front 37

describe the shape of the articular processes of the lumbar vertebrae and explain how their shape affects their motion

Back 37

Stout, cup-like articulations allow for rotation and provide significant stability

Front 38

what are the 4 normal movements of the vertebral column

Back 38

1. flexion (touch your toes)
2. extensino (lean backwards)
3. lateral flexion (run hand down side of leg)
4. Rotation

Front 39

The joint formed by the articulating processes of adjacent vertebrae is called

Back 39

facet/ zygapophyseal

Front 40

What type of joints are those formed by vertebral bodies

Back 40

symphyses (secondary cartilainous)

Front 41

What are the two types of joints found in the vertebral column

Back 41

1. facet/ zygapophyseal- formed between articular processes of adajecnt vertebrae
2.symphyses- formed by vertebral bodies and IV disks

Front 42

Describe the structure of an IV disk

Back 42

annulus fibrosus- fiberous material that makes up the outside of the disk
nucleus puposus- jelly material that makes up the inside of the disk

Front 43

what is the spinal dural sac

Back 43

formed by the dura mater, long tubular sheath within the vertebral canal, adheres to the margin of the foramen magnum (continuous with cranial dura), ends in the filum terminale externa

Front 44

what is the difference between the filum terminale interna and the filum terminale externa

Back 44

interna- pia mater extension within the dural sac
externa-formed by the dural sac and the filum terminale interna, anchors the spinal cord and mennges to the coccyx

Front 45

Describe the two main areas of blood supply to the spinal cord

Back 45

Anterior spinal artery- arises from the vertebral arteries and unites to form a single artery which travels the midline spinal cord and supplies the anterior 2/3
posterior spinal arteries- arise from the vertebral arteries and travel just posterior to the dorsal horn of the spinal cord (bilateral) and supply the remaining 1/3 of the spinal cord

Front 46

How does the anterior and posterior spinal blood supply differ structurall

Back 46

Both blood supplies arise at he vertebral arteries.
Anteriorly the arteries unite and form a single artery which supplies the anterior 2/3 of the cord
Posterior- There are two posterior spinal arteries (the vertebral arteries do not unite) which run bilaterally and supply the posterior 1/3 of the spinal cord

Front 47

The anterior and posterior spinal arteries only supply the upper cervical region of the spinal cord. What supplies the lumbarsacral cord

Back 47

The great radicular artery at T12

Front 48

The blood supply delivered to the cervical region of the spinal cord by the anterior and posterior spinal arteries is supported by...

Back 48

the radicular arteries which are branches off the posterior intercostal arteries which stem from the aorta

Front 49

Trace the path of the blood vessels that provides support and supply the lower regions of the spinal cord

Back 49

aorta => posterior intercostal arteries => radicular arteries

Front 50

Occulusion of the anterior spinal artery will intially affect... function (sensory or motor)

Back 50

Motor.
The anterior spinal artery supplies the ventral roots which are involved with motor signals

Front 51

T/F Dorsal rami carry only sensory information

Back 51

false. Rami are mixed nerves and carry both sensory and motor information. Do not confuse rami with roots which do split the info (ventral root= motor, dorsal root= sensory)

Front 52

Herniation at the L4/L5 disk would pinch which nerve?

Back 52

L5.
The lumbar nerves exit below their vertebrae so you would think that it would be L4 however the L4 nerve exits the spinal column wel above the disk space. The L5 nerve however, passes right over the disk on its way to exit below the L5 vertebrae

Front 53

What nerve exits the spinal cord between C7 and T1

Back 53

C8

Front 54

myotome

Back 54

all of the striated muscle fibers innervated by a given cord segment

Front 55

dermatome

Back 55

area of skin innervated by a given spinal cord segment